Comparative Pharmacology
Head-to-head clinical analysis: EXALGO versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXALGO versus OPANA.
EXALGO vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Mu-opioid receptor agonist; inhibits ascending pain pathways and alters pain perception and emotional response to pain.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
Initial: 8 mg orally every 24 hours for opioid-naive patients; titration based on response; maximum 32 mg daily.
5-20 mg orally every 4-6 hours as needed for pain; extended-release tablets: 5 mg orally every 12 hours, titrated up to 20 mg every 12 hours.
None Documented
None Documented
Terminal elimination half-life: approximately 15-18 hours in healthy adults. Steady state is achieved by 3-5 days. In patients with hepatic impairment, half-life may be prolonged up to 24-27 hours.
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
Renal: primarily as hydromorphone-3-glucuronide and unchanged drug (~40% as glucuronide conjugates, ~3% as unchanged hydromorphone). Fecal: minimal. Total renal clearance accounts for ~50% of drug elimination.
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic